肾穿刺术后护理的新进展

近年来，肾穿刺活检技术已广泛应用于临床，通过此项检查能够明确肾脏疾病的病理学分型和免疫学分型，指导正确用药及判断预后。因此，关于肾穿刺术后的护理尤其是术后监测生命体征、卧床时间及是否用沙袋加压止血等问题已引起临床重视，而且国内外许多专家就此提出了不同的观点。本文对肾穿刺术后护理的新进展作一综述。     

1例食管裂孔疝术后合并肺不张的护理

食管裂孔疝指腹腔内脏器（主要是胃）通过食管裂孔进入胸腔所致的疾病。食管裂孔疝是膈疝中最常见的，占膈疝的90％以上。食管裂孔疝患者可无症状，或症状轻微，其症状轻重与疝囊大小，食管症状的严重程度有关。     

慢性乙型肝炎,肝癌的ICA—1表达及细胞因子对ICAM0—1的调节作用

目的 研究细胞间粘附因子－１（ＩＣＡＭ－１）在乙肝炎病毒（ＨＢＶ）消除及肝癌免疫机制中的意义。同时探讨细胞因子对ＩＣＡＭ－１的调节作用。方法 利用免疫组化技术对ＨＢＶ相关肝病肝组织ＩＣＡＭ－１表达进行检测；利用细胞酶联免疫技术。观察ＩＦＮ－γ，ＩＦＮ－α，ＴＮＦ对人肝癌细胞Ｈ－７４０２ＩＣＡＭ表达的调节作用。结果 在ＣＨＢ中，ＩＣＡＭ－１表达愈强，肝内ＨＢｅＡｇ表达愈少；细胞因子对ＩＣＡＭ－１表达     

血流变测定在脑出血与脑梗死中的应用

观察血液流变学在缺血性脑血管病与出血性脑血管病急性期的改变。通过对脑梗死78例及脑出血80例急性期血流变的检测，发现低切黏度、高切黏度、红细胞聚集指数及血细胞比容等在两组间差异显著（P＜0.05），认为血流变学的测定对脑梗死的应用价值较大。     

不停抖动的“不宁腿”

杜先生做梦也没有想到,一觉醒来,自己就成了个"不倒翁"。8个月前的一天早上,杜先生起床刷牙,左腿突然就开始颤抖,整个身体都前后摇晃,像个不倒翁,走路需要家人搀扶。最痛苦的是晚上睡觉时因为左腿不由自主地不停摇摆,根本无法入睡。     

颈动脉斑块高分辨MRI评价阿托伐他汀联合红花黄色素对颈动脉斑块的影响

目的通过颈动脉斑块高分辨MRI检查评价他汀类联合红花黄色素对颈动脉斑块的影响。方法前瞻性选取2015年4月至2015年10月沧州市人民医院神经内科经颈动脉高分辨MRI检查显示颈动脉存在斑块者40例。将其随机分为对照组(n=20)和试验组(n=20)。对照组睡前口服阿托伐他汀钙20 mg,每天一次;试验组睡前口服阿托伐他汀钙20 mg,每天一次,联合注射用红花黄色素100 mg加入0.9%氯化钠注射液250 ml中,静脉缓慢滴注,每天一次。两周后,比较两组患者血脂水平和颈动脉斑块长度、厚度、最大横截面积。结果两组治疗后血清总胆固醇、低密度脂蛋白胆固醇及甘油三脂均较治疗前明显降低,差异具有统计学意义(P0.05);高密度脂蛋白胆固醇水平与治疗前比较,差异无统计学意义(P0.05)。两组颈动脉斑块长度、厚度、最大横截面积均较治疗前减少,差异有统计学意义(P0.05)。试验组治疗后TC、LDL-C、TG及血管斑块长度、厚度、最大横截面积均明显低于对照组,差异有统计学意义(P0.05)。结论利用先进的颈动脉斑块高分辨MRI定量检测患者颈动脉斑块的变化,更为客观准确地证实阿托伐他汀钙联合红花黄色素在降脂、逆转颈动脉斑块方面有确切的疗效。     

血细胞分析溯源工作的现状与方法

近年来，血细胞分析的准确性得到了医学领域的广泛重视，但在各级医院临床实验室的血细胞分析溯源工作仍然存在需要改进的部分。临床实验室必须从规范血细胞分析的溯源管理入手，才能确保血细胞检测系统结果的准确可靠。本文对校准品、质控品的选择和使用，以及如何建立系统的溯源体系，合理的做好定期校准和日常质控两方面的工作提出了意见和建议。     

人组织因子途径抑制物基因在兔颈动脉损伤血栓形成中的作用

Objective To observe the effects of tissue factor pathway inhibitor(TFPI) on thrombosis formation in rabbit carotid arteries after ballon injury. Methods Fouty rabbits with the weight 2.5-3.0 kg were respectively divided into 4 groups, Ad-TFPI, Ad-LacZ, PBS and normal control groups. The normal control group was not given any treatment and other 3 groups were given 0.2 ml Ad-TFPI, Ad-LacZ or PBS reproduced by the Dispatch catheter respectively after the PTCA balloon iniury on the right carotid arteries. Ten days after gene transfer the repeated balloon injury was performed in the 3 groups, and the first balloon injury was performed in the normal control group by the same method. The carotid blood flow was recovered immediately after the injury. Thirty minutes later all the animals were sacrificed. The injured carotid arteries and one part of contralateral normal artery were cut down, scissored along the long axis, flattened and fixed in the 2% glutaral. The platelet aggregation and thrombosis formation on the luminal surfaces was observed under electron microscope. Results The electron microscope results showed that the vascular endothelial cell structure was integrated and lined up in order in the nomal artery which had no any injury. After the balloon injury in the normal control group, the structure of the endothelial cell was disintegrated, and there was some platelet aggregation but no fibrosis formation. A large amount of platelet aggregated but no fibrosis formed in Ad-TFPI group after the repeated balloon injury. A large amount of fibrosis formed and red cells piled up in the Ad-LacZ and PBS group. The positive rate of thrombosis formation among groups had siginificant differences(χ2=14.95, P<0.01). The positive rate in Ad-TFPI group(20%) was lower than that in Ad-LacZ group(80%, χ2=7.20, P<0.01) and PBS group(70%, χ2=5.05, P<0.05), but was higher than that in the normal control group(10%, χ2=0.39, P>0.05). The positive rate in Ad-LacZ group(80%) was higher than in the normal control group(10%, χ2=9.90, P<0.01) and in the PBS group(70%, χ2=0.27, P> 0.05). The positive rate in PBS group(70%) was higher than that in the normal control group(10%, χ2=7.50, P< 0.01). Conclusions The repeated balloon injury method can cause a large amount of fibrosis formation in the rabbit carotid. TFPI gene inhibits thrombosis formation in balloon-injured rabbit carotid arteries.     

痰热清治疗失代偿肝硬化并急性肺炎的疗效观察

失代偿性肝硬化是各种慢性肝病的晚期阶段，主要表现为肝细胞功能衰竭，机体免疫防御功能低下，易发生各种感染，肝硬化患者为急性肺炎的易感人群之一，而急性肺炎起病急，临床症状多为发热、咳嗽、咳黄白色或黄色粘痰和胸痛等症状，因此临床选择具清热、解毒、化痰多种药效为一体而对肝脏没有损害或基本没有损害的药物具有十分重要的意义。为此，我科采用痰热清注射液治疗失代偿肝硬化合并急性肺炎，并设对照组加以比较，由此探讨痰热清的疗效及对肝脏的影响。